GPs are not the villains

4th November 2008

The journal Pulse argues that GPs are not the villains in the referrals crisis.

GPs are being accused in the national media of allowing money to influence their clinical decisions. It is a notion that is against GMC rules and is also against the essence of what it means to be a good GP.

But it is a financial crisis caused by soaring GP referrals that lies at the root of the problem with Primary Care Trusts facing overspends of up to £20m.

As so often seems to be the case, they are turning to GPs for a solution.

But GPs are "distinctly queasy" about the financial incentives to change their referral habits.

Those who sign up are condemned and those who refuse find themselves blamed for other patient services being scrapped to offset deficits.

It is another case of GPs being "damned if they do and damned if they don't."

The GMC has warned that GPs are walking a tightrope but if there was ever a case of doctors being vilified for a problem that was not their making, then this is it.

The 16% year-on-year increase in referrals remains unexplained but the factors cited by GPs offer an explanation: the scramble to cut bed-days and hospitals banning consultant-to-consultant referrals in an attempt to hit their 18-week wait targets.

What is needed is an inquiry and one that will look at how much of the problem is down to changes in GP referral patterns and what is due to changes in hospital policies.